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Patient-Driven SNF Payment Model Will Go into Effect October 1, 2019

July 16, 2019

McDermott+Consulting

In July 2018, the Centers for Medicare and Medicaid Services (CMS) finalized a new payment model to overhaul the current methodology for classifying patients under the skilled nursing facility (SNF) prospective payment system. Replacing the Resource Utilization Group-IV (RUG-IV) patient classification system, the newly approved Patient Driven Payment Model (PDPM) will take effect on October 1, 2019. This new model classifies patients into payment groups based on specific, clinically significant factors rather than volume-based services.

There is a hard transition between SNF payment models. All RUG-IV payments will end on September 30, 2019, and all PDPM payments will begin on October 1, 2019.

For more information about PDPM, see the CMS webpage for related fact sheets, FAQs and related coding crosswalks/classification logic.

 


For more information, visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at +1 202 204 1459 or smadhani@mcdermottplus.com.

 

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